Objective      To evaluate the clinical significance of serum procalcitonin (PCT) levels in the early diagnosis and severity assessment of urosepsis in patients after percutaneous nephrolithotomy (PCNL) by dyn

amic monitoring for its levels.       Methods      Clinical data of 917 patients with upper urinary tract stones undergoing PCNL in our department from September 2011 to December 2012 were collected and retrospectively analyzed in this study. They were 517 males and 400 females

and at a mean age of 50.6±15.4. The vital signs

serum PCT levels and white blood cells (WBC) count of patients were determined during the perioperative period. The severity of urosepsis was evaluated with the sequential organ failure assessment (SOFA) score. The serum PCT and WBC count were compared in the patients with differences severity of infection after surgery

and the value of serum PCT and WBC count were assessed in the early diagnosis of postoperative PCNL urosepsis.       Results      Among the 917 cases undergoing the primary PCNL

779 patients had no postoperative infections and served as control group. There were 31 patients with fever

and 107 patients with urosepsis. Among the 107 patients with urosepsis

there were 34 patients with severe sepsis

and 7 patients with septic shock. According to the SOFA score

the urosepsis patients were divided into 3 groups with score of 0 to 8 (n=83)

9 to 16 (

n

=16)

and 17 to 24 (

n

=8) respectively. Significant differences were seen in the serum PCT level among the groups of control

simple fever

sepsis

severe sepsis and septic shock (

P

0.05)

and among those with different SOFA scores (P0.05). Similarly

significant differences were found in WBC counts among the groups of control

simple fever

and sepsis (

P

0.05)

but not between the groups of severe sepsis and septic shock

or between the groups of SOFA 9-16 and 17-24 (

P

0.05). The serum PCT level had higher sensitivity

specificity and positive likelihood ratio

and lower negative likelihood ratio in the early diagnosis of postoperative-PCNL urosepsis than WBC count.       Conclusion      The serum level of PCT is obviously correlated with the severity of infection after PCNL. Dynamic monitoring of

the serum PCT level is of important clinical value for early diagnosis of urosepsis and timely judgment of postoperative-PCNL urosepsis progression.